Upgrade to an Assistant Instructor Membership

Please complete the information below to apply for your Assistant Instructor Membership.

Thank you for your interest! Assistant Instructor memberships are appropriate for individuals that teach at a school where the owner has already become an Affiliate School Member. If you are a school owner, upgrade to the Affiliate School Membership instead.

First Name (required)

Last Name (required)

Date of Birth (required)

Male/Female (required)

Street Address (required)

City (required)

State/Province (required)

Postal Code (required)

Country (required)

Home Phone (required)

Academy Phone

Mobile Phone (required)

Email Address (required)

Affiliate/School Name (required)
I am applying for Assistant Instructor under the following affiliate member school.

Website

Previous Experience in Martial Arts

Instructor Name and Contact Info

WTBA Rank (If any)

Tell us a little bit about yourself